As Colorectal Cancer Awareness Month, March is an ideal time for people ages of 45 and up to talk to their health care provider about getting screened for colorectal cancer, including colon cancer and rectal cancer.

One in 23 men and one in 26 women will develop colorectal cancer, according to the Colorectal Cancer Prevention Network at the University of South Carolina.

Excluding skin cancers, colorectal cancer is the third most diagnosed cancer in the U.S. 

Colorectal cancer is expected to cause 53,000 deaths this year, according to the American Cancer Society – but experts estimate that 60% of those deaths could be prevented through screening tests that can lead to early detection.

“The earlier colon cancer is caught, the more effective surgery is and the higher likelihood of cure,” said Dr. Brian Sadowski, a gastrointestinal surgeon at AnMed. “While bowel issues are often uncomfortable to talk about, discussing them with your doctor, especially if there are abnormalities, is very important because it may justify an exam sooner than standard.”

Colorectal cancer rates rising in people under age 50

Thanks largely to more widespread screening, the overall incidence and mortality rates of colorectal cancer have decreased in recent decades. 

For unknown reasons, however, the incidence rate of colorectal cancer has been rising in individuals under age 50 since the mid-1990s. Colorectal cancer mortality rates for people under age 55 are also increasing.

As a result of these troubling trends, the recommended age to begin colorectal cancer screenings has been lowered from 50 to 45.

“Give the significant increase in cancer in these younger patient populations over a relatively short period of time, I think it is likely related to dietary and environmental factors, although the exact cause is still not clear,” Dr. Sadowski said, “Nevertheless, our standard screening is very effective in these younger patients as well, and we are hopeful that lowering the screening age will help drop the cancer rates in these young patients as it has successfully done in our older patients.

“For our young patients, probably the most important thing to know is that they cannot ignore symptoms. Bleeding, change in bowel habits and pain are all symptoms that should not be ignored and should be brought to the attention of your doctor, who can decide whether further testing is appropriate.”

Here’s more you should know.

What is colorectal cancer?

Growths called polyps can form in the colon or rectum. Over time, some polyps can become cancerous. 

Screening tests can find polyps, allowing them to be removed before they turn into cancer. These tests also can detect colorectal cancer at the earliest stages when treatment is most effective.

Risk factors for colorectal cancer

About 55% of colorectal cancers in the U.S. are attributable to potentially modifiable risk factors. These factors increasing your chances of colorectal cancer include:

• Excess body weight
• Physical inactivity
• Long-term smoking
• High consumption of red or processed meat
• Low calcium intake
• Heavy alcohol consumption
• Very low intake of fruits and vegetables and whole-grain fiber.

Hereditary or genetic and medical factors that increase risk of colorectal cancer include:

• Personal or family history of colorectal cancer
• Certain inherited genetic syndromes
• Personal history of chronic inflammatory bowel disease 
• Personal history of type 2 diabetes

Signs and symptoms of colorectal cancer

While many people never experience any symptoms before they are diagnosed with colorectal cancer, there may be some warning signs. Regardless of your age, contact your health care provider if you experience:

• Ongoing changes in bowel movements
• Narrow or pencil-thin stools
• Bright red or dark blood in toilet or on stool
• Blood on toilet paper after a bowel movement
• Unexplained anemia
• Weakness or fatigue
• Unexplained weight loss
• Abdominal fullness, pain or cramping

Types of screening tests for colorectal cancer

Your primary doctor can help you determine which tests you might need based on your health history, family history, age and other factors. 

Colonoscopy is the most commonly offered screening for colorectal cancer. During a colonoscopy, a doctor uses a thin, flexible, lighted tube to check for polyps or cancer inside the rectum and colon. Most polyps and some cancers can be found and removed during this test.

Stool-based testing options are available, too, and can be performed at home.

Other screening tests include:

• Fecal immunochemical test (FIT) – uses antibodies to detect blood in the stool.
• Multi-targeted stool DNA test, commonly known as Cologuard – checks a stool sample for blood and genetic mutations linked to cancer.
• Flexible sigmoidoscopy – inserts a thin tube with a light and camera into only the lower part of your colon to look for polyps that could be cancerous.

What if cancer or cancer is found? There are options

If colorectal cancer is found during a screening, options are available.

“Colorectal cancer is a very treatable disease, especially if caught early,” Dr. Sadowski said. “This is why screening is so important. The closer we follow patients with screening, the more likely we are to catch an early cancer and the more successful the treatment is. Cure rates for early stage cancer are very high. Depending on the location of the cancer and how advanced it is at the time of diagnosis, colon and rectal cancer may be treated with chemotherapy, radiation, surgery or a combination of these.

“In terms of surgery, many colon and rectal operations can be performed laparoscopically or with the surgical robot, which means the incisions are smaller, postoperative pain is less and recovery from surgery is faster.”

For more information, visit anmed.org/services/cancer-care/types/colon-rectal.